DTIC ADA498339: Journal of Special Operations Medicine. Volume 2, Edition 1, Winter 2002

85 Pages·6 MB·English

by  Defense Technical Information Center

Winter 2002
Volume 2, Edition 1
A Peer Reviewed Journal for SOF Medical Professionals
Winter Training
Dedicated to the Indomitable Spirit & Sacrifices of the SOF Medic
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From the Surgeon
Greetings again from HQ USSOCOM!
This Journal remains a viable tool for us to spread the word and share medical information between
each level of medical support. Our forces have been deployed into Operation Enduring Freedom for sev-
eral months now. We here in this headquarters are beaming with pride at the professionalism demonstrat-
ed by our SOF forces, and in the quality of the medical care rendered to our forces by the Medics, Corpsmen
and PJs in the field. We get daily status reports from the hospitals in Europe caring for casualties of this
deployment, and the medical personnel charged with their care have performed superbly from the point of
injury/illness through evacuation to CONUS Medical Centers.
As this campaign unfolded, we "chopped" as much of our staff to help CENTCOM as needed for
this effort. Our guys, in concert with the CENTCOM/SG staff, put together a medical annex to the "big"
plan that was awesome given the tyranny of distances involved. We even sent one of our medical planners
as the JSOCC-SG forward. Bottom line is that all is working well.
So, why do I bring it up? Early in the operation I began to get a little nervous that we had this big
plan and we medics hadn't shared the details with the Line leadership here. I had a meeting with the CINC
on another matter, and finally said that we here were supporting CINC CENTCOM and SOCCENT and that
we were very happy with the plan. I offered to bring him a briefing on the "nuts and bolts" of the medical
annex hoping that his approval would give us all a "warm fuzzy". He simply told me that he didn't need a
briefing, "but we had better be happy with the plan; those are our people over there!".
So, he trusts us with the plan and we trust the operators to pull it off. As folks come back and rede-
ploy, pick their brains, get their experiences on paper, find the shortfalls and let us know what they need to
continue their successes. The forces we deploy are so highly skilled and trained they are national treasures.
Bust your butt to find new and better ways to support them in their attack on the terrorists. Pass the word,
let us know, keep on keepin on!
God Bless America
dhammer
Dave Hammer (center) 1st Marines,
Fleet Marine Force Pacific, Winter 1959
Third Battalion, 10th Special Forces out of Fort Carson
near Colorado Springs, CO train at Crested Butte.
Sgt. First Class Gabe Maillet, Master Ski Instructor,
instructs an advanced class.
Photographs by: Joseph Rehana
The Journal of Special Operations Medicine is an authorized official quarterly publication of the United States Special
Operations Command, MacDill Air Force Base, Florida. It is in no way associated with the civilian Special Operations Medical
Association (SOMA). Our mission is to promote the professional development of Special Operations medical personnel by pro-
viding a forum for the examination of the latest advancements in medicine.
The views contained herein are those of the authors and do not necessarily reflect official Department of Defense posi-
tion. This publication does not supercede any information presented in other Department of Defense publications.
Articles, photos, artwork, and letters are invited, as are comments and criticism, and should be addressed to Editor,
Journal of Special Operations Medicine, USSOCOM, SOC-SG, 7701 Tampa Point Blvd., MacDill AFB, FL 33621-5323.
Telephone: DSN 968-5442, commercial: [phone], fax: -2568; e-mail [email protected].
All scientific articles are peer reviewed prior to publication. The Journal Of Special Operations Medicine reserves
the right to edit all material. No payments can be made for manuscripts submitted for publication. Published works may be
reprinted, except where copyrighted, provided credit is given to the Journal of Special Operations Medicine and the authors.
From The Staff
As we continue to involve you, our readers, in the production of this journal, your submissions and photos are what are
needed to make this journal unique. It is a sharing of your missions and your lives as you go forth as instruments of national
foreign policy. We can’t do it without your input. You are what the journal is all about.
This journal is one of the most excellent and righteous tools we have to span all the SOF services, to share medical infor-
mation and experience unique to this community. The JSOM survives because of generous but time-consuming contributions
sent by clinicians, researchers and former medics from all the services who were SOF qualified and/or who served with SOF
units. We need your help. We are always looking for SOF-related articles from current and/or former SOF medical veterans.
If you have contributions great or small…f ire ‘em our way. Our E-mail is: [email protected].
A recent addition to the JSOM is the offering of CMEs. We are currently working with USUHS, our sponsor for CMEs for
the physicians, PAs and nurses, starting with this edition. In this edition, you will find CMEs offered on “Part 1- Dive Medical
Brief ” (Part 2 will be in our Spring Edition) and “Prehospital Treatment of Hypothermia” articles.
In this edition of the JSOM, we honor our fallen brother, MSG Jefferson D. Davis, killed in support of Operation ENDURING
FREEDOM .
Word from the "field", our readers, is that they would like to see the following types of articles in future JSOMs.
Articles that entail and involve the following: Tricks of the Trade…anything from simple more effective bandaging to doing
more with less (supplies, meds), keeping IVs warm, treatment of hotspots and blisters, Colloids vs. Crystalloid fluid replace-
ment, IV infusion in extremities vs. intraosseous fluid infusion; Poor-mans Gatorade recipe, improvised laxatives or antidiar-
rheals or anything improvised for that matter; herbal medicine…any relevance or uses that are legitimate; articles dealing with
trauma, infectious disease processes and/or environment and wilderness medicine type articles; more photos accompanying the
articles or alone to be included in the photo gallery associated with medical guys and/or training.
The fact is most everybody that has read an article on a technique or concept knows of another way of doing the same thing
that's perhaps faster, easier, or dare I say...better. Just like any patrol or observation of a target…the more eyes the better. If
you, the readers, have knowledge of such things as listed above or at least know where to find info on a particular subject…let
us know here. We’ll hunt down where you think you saw that information and see if we can't either re-print it for the rest of
the readers or at the very least pass along where information of interest can be found. OK enough said…keep your eyes open
and let us know. Thanks.
Lastly, our distribution list continues to expand daily. Requests for the journal have come from all services: from
medics to physicians, from clinical to operational units as well as from the retired and civilian communities. We are doing our
best to see that all who will benefit from the journal receive it.
Enjoy this edition of the journal, send us your feedback, and get those article submissions in to us: [email protected].
sea/mdd
Volume 2, Edition 1 / Winter 02 1
Meet Your JSOM Staff
EXECUTIVE EDITOR
David L. Hammer, MD
[email protected]
Colonel Hammer’s military and medical career began in 1958 when he
served as a U.S. Navy Combat Medical Corpsman attached to U.S.
Marine Corps infantry, artillery, and communication/reconnaissance
units. Following discharge, he completed his BS and MD degrees at the
University of Michigan in 1967 and 1970 respectively. Following nine
years of civilian medical practice in a multi-specialty group in Grand
Rapids, Michigan, he reentered military service as a Flight Surgeon at
Beale AFB. In 1984, he completed the Air Force Residency in Aerospace
Medicine at Brooks AFB, Texas, during which period he earned a Masters
in Public Health Degree from Harvard University. Colonel Hammer has spent the majority of his career in
aerospace medicine and direct line support assignments, has commanded three medical groups, and has been
assigned to the ARRS/SG, the AFSOC/SG and the USAFA/SG. He is a chief flight surgeon and a master para-
chutist.
MANAGING EDITOR PRODUCTION EDITOR
Steve E. Anderson, PA-C Michelle D. DuGuay, RN
[email protected] [email protected]
CPT Anderson enlisted in the Army in 1980. Upon Maj DuGuay joined the Army Reserve in 1987 and
completion of the Combat Medic course, he volun- served as a nurse in a Combat Support Hospital unit
teered for Airborne and Special Forces training. for three years before switching services in 1990 to
Assignments encompassing 13 years as a SF medic become an Air Force C-130 Flight Nurse. She is cur-
include: Team medic-C/3/10th SFG(A), Instructor at rently a reservist attached to the USSOCOM/SG
Med Lab-Ft Bragg and Medic-1st SFOD-D. CPT office. Maj DuGuay has a BSN and is currently
Anderson was accepted to the Military Physician obtaining her MBA with a concentration in manage-
Assistant program and subsequently commissioned ment. Her skills include being a flight nurse (both
in 1995. Assignments from that time to present military and civilian), 15 years of critical care and
include: 1/9th INF Regiment, 2/504th PIR, 82d Abn emergency room nursing experience, an EMT and a
DIV, 2/7th SFG(A), and currently assigned to the legal nurse consultant. She has also served as the
USSOCOM Surgeons Office as the Command PA. military liaison to her FL 3 Disaster Medical
Education and qualifications include: B.S. Southern Assistance Team (DMAT). Prior to the SG office,
Illinois University 1979, B.S. University of Maj DuGuay’s experience at USSOCOM included
Oklahoma 1995, and MPAS University of Nebraska- an assignment in the Center for Force Structure,
1997, Jump Master, SERE, HALO, Combat Diver, Resources, Requirements, and Strategic
Dive Medical Technician, Flight Surgeon, Dive Assessments.
Medical Officer.
2 Journal of Special Operations Medicine
Journal of Special Operations Medicine
EXECUTIVEEDITOR
Hammer, David L., MD
MANAGING EDITOR [email protected] PRODUCTION EDITOR
Anderson, Steven E., PA-C DuGuay, Michelle D., RN
[email protected] [email protected]
EDITORIAL BOARD
Senior Editor:Anderson, Warner J., MD
Heintz, David S., MSPM Lundseth, Paul, MD
Parsons, Deborah A., RN Clayton, Robert T., SVERDRUP
Officer CME MANAGERS Enlisted
Parsons, Deborah A., RN Robert McCumseyA., EMT-P
[email protected] [email protected]
CME REVIEW BOARD
Clifford C. Cloonan, MD John M. Wightman, MD
EDITORIAL CONSULTANTS
Ackerman, Bret T., DO Kinkead, Bert E., MBA
Allen, Robert C., DO Llewellyn, Craig H., MD
Anderson, Steven E., PA-C Lockette, Warren, MD
Bearden, Clint E., EMT-P Lorraine, James R., RN
Bourne, Peter G.,MD Jackson, Michael A., PA-C
Brannon, Robert H., FACHE Keenan, Kevin K., MD
Briley, Daniel S., PA-C Klienschmidt, Paul K., MD
Brochu, Michael A., EMT-P Knauff, Glenn D., EMT-P
Brown, William E., EMT-P LaPointe, Robert L., SMSgt (Ret.)
Burdish, John P., PA-C Lutz, Robert H., MD
Butler, Frank K., MD McAtee, John M., PA-C
Cavolt, Brian W., IDC Miller, Robert M., EMT-P
Collins, Marlise R., MD Nelon, Earnest L., MSSI
Compton, Shon D., PA-C Pease, Peter J., EMT-P
Darby, William M., MPH Pennardt, Andre M., MD
Davis, Harley C., MG (Ret.) Philippi, Alan F., MD
Davis, William J., COL Polli, Dennis M., IDC
Descarreaux, Denis G., OD Porr, Darrel R., MD
Dougherty, James J., MD Reed, Hadley B., MD
Durck, Craig H., DO Richards, Thomas R., RADM (Ret.)
Eacrett, Edward D., PA-C Rhinehart, Michael E., EMT-P
Edwards, Curt E., EMT-P Riley, Kevin F., MS
Evans, Everett E., EMT-I Rooney, Richard C., MD
Frame, Robert T., DMD Schoomaker, Peter J., GEN. (Ret.)
Farr, Warner D., MD Schroer, David J.
Gandy, John J., MD Short, Jeffrey E., MD
Garsha, Larry S., MD Shipman, Donald G., PA-C
Gerber, Fredrick E., MMAS Singer, Darrell, MD
Giebner, Steven D., MD Smith, Louis H., PA-C
Giles, James T., DVM Swann, Steven W., MD
Godbee, Dan C., MD Uhorchak, John M., MD
Hartman, Richard T., MS Vanderbeek, James, D., MD
Hlavnicka, John L., CRNA Wedam, Jack M., DVM
Holcomb, John B., MD Wilkinson, Michael D., Ph.D
King, Jeffery S., MS Yevich, Steven J., MD
Volume 2, Edition 1 / Winter 02 3
Contents
Winter 2002 Volume 2, Edition 1
Departments
Component Surgeon Offices 5 Legacy 56
The “DOC” is in
Warner Farr, MD USASOC
Leonard D.Blessing Jr.
Larry Garsha, MD NAVSPECWARCOM
Jim Dougherty, MD AFSOC
Expedient Medic 59
Education and Training 16
Antibiotic Use in the Austere Environment
Medical Risk Assessments: Expanded Mission for
Part 1-Upper Respiratory
SOF Medical Personnel
Warner Anderson, MD
William M. Darby, MPH, MEPM, REHS
SAM Splints for Special Ops Medicine
Sam Scheinberg
Research & Development 20 There I Was... 66
Functions of the Biomedical Initiatives Steering A Memorable Mission
Committee Wayne Fisk
Mr. Robert Clayton, SVERDRUP OPERATION "JUNGLE JIM"
Hap Lutz
Features
Dive Medical Brief: A Comprehensive Review 22
Correspondence Letters to the Editor & Apologies 72
for the Special Forces Dive Medical Technician
Eric D. Martin, DO
1.75 CME--2.0 CNE/CEH
The Lost Art of Mule Packing in the U.S.Army 31 Editorials 74
Michael B. Lennon, VMD, PhD
Prehospital Treatment of Hypothermia 35
Gordon G. Giesbrecht, PhD
1.25 CME--1.5 CNE/CEH
Med Quiz 76
NVG Injuries in U.S.Army Aviation 43
Paul A. Cain, MD ChB
John S. Crowley, MD
Photo Gallery 78
CME Test Questions 49
Dive Medical Brief
Prehospital Treatment of Hypothermia
Dedication 80
SOMA Update 54
Jefferson D. Davis
4 Journal of Special Operations Medicine
USASOC
Below is an accounting of the USASOC
Surgeon's Conference this December in Tampa.
After concentrating on Guerrilla Warfare (GW) Rocky Farr, MD
for the weekend and for a week of the Special COL, USA
Operation Medical Association (SOMA) confer- Command Surgeon
ence, I was fortunate enough to make it forward
to the war. GW is alive and well & our guys are
Editors Note: After several months of coercion, COL
doing it great. Robin Sage in action. Thanks,
Farr has provided the JSOM an updated photograph.
Rocky
The previous photo was CIRCA 1969 in the Republic
of Vietnam. This new photo was recently taken in
2001 USASOC COMMAND SURGEON’S
Afghanistan.
CONFERENCE
AFTER ACTION REPORT (AAR)
by LTC Michael Mouri tours are available from 90 to 179 days. Special
forces medical sergeant (SFMS) consists of special
The 2001 USASOC Command Surgeon’s operations combat medic (SOCM) and advanced
Conference was held 8-10 December 2001 at the special operations combat medic (ADSOCM). For
Hyatt Regency Hotel, Tampa, FL. the SEALs, ADSOCM is special operations inde-
Hosts: COL Farr, USASOC Command Surgeon, pendent duty corpsman (SOIDC). Sick Call is now
COL Diamond, USASOC IMA Command Surgeon, incorporated in SOCM using the Navy Sick Call
COL Keenan, JSOMTC Dean & USAJFKSWCS Screener Curriculum. The DOT 2000 update of
Surgeon, COL Anderson, USASOC Surgeon’s Staff EMT-P certification recommends 1200 hours of
Attendees: HHC--CPT Schob, MSG Capuzzo, LTC training excluding the EMT-B and A&P prerequi-
Mouri; GSC--CPT Settle; 1st Bn--CPT Hamada, sites. SOCM provides 948 hours and now awards
MSG Long; 3rd Bn--MAJ Butler, CPT Garrett; 350 the 91WW1. ADSOCM/SOIDC provides 1032
CA--COL Jenkins, LTC Ward, LTC Weaver, LTC hours and re-establishes medical acumen, reinforces
Adams, LTC Milligan, LTC Cunningham, MAJ anesthesia including inhalational, and provides
Allen; other CA and SF units minus 5th Group, 75th unconventional warfare/guerrilla warfare (UW/GW)
Ranger Regiment, 160th SOAR nursing skills. One day of dental training is lost.
The medical sustainment requirements for 18Ds
Presentation Topics: remain the same: Special Operations Forces
Medical Training: There are now six 61N Flight Medical Skills Sustainment Program (SOFMSSP),
Surgeon individual mobilization augmentee (IMA) Medical Proficency Training (MPT) and Non-trau-
slots at the JSOMTC with curriculum responsibility ma modules (NTM) every two years. All SF groups
for 30 days of the 18D training calendar. Volunteer except the 19th now have local MPT training sites.
5
Volume 2, Edition 1 / Winter 02
Our site is the Birmingham VA Hospital, which in one year and all females must have a UPT 48
requires a minimum 30-day advanced notice before a hours before deploying. CHRs continue while
rotation is established. Our memorandum of under- deployed. Complete the weekly DNBI report while
standing (MOU) must be renewed every two years. deployed as well as those on the reportable medical
All MPT rotations require that the 18D maintain event list. Within 5 days of redeploying, present
a patient contact journal with age, gender, diag- redeployment medical briefing, complete DD2796
nosis and procedures performed. A case study is and consider drawing serum to be stored in the DOD
mandatory and will be sent to USASOC Surgeon Serum repository on everyone with a possible expo-
for entry into an 18D archive. The two primary sure. TB skin testing should be done 3 months postde-
unassigned sites remain Shock Trauma in Baltimore, ployment.
MD and the Navaho Indian Hospital in Shiprock, Med Intel: Dave Passaro, who is also an
NM. Pending sites include a two-week anesthesia 18D with 19th SFG (A), works with CSM Betty Rice
rotation at Charlotte Hospital and a four-week surgi- as an S-2 officer. Information sources include
cal rotation at the University of Cincinnati. Travax from Department of State, Disease and
Continuing medical education (CME) hours may be Environmental Alert Reports (DEARS) now know
possible through the JSOMTC but it will not be easy as Armed Forces Medical Intelligence Center
and it remains at the bottom of the priority list at this Medical Environmental Disease Intelligence and
time. CME is available for paramedics in the Counter-measures (AFMIC MEDIC CD-ROM),
JSOM. environment, climate, water, blood, hyperbaric
Physical Examination: Approval for all chambers, waste, plants & animals, health service
Special Warfare Center and School (SWCS) physi- assessment, foreign medical facilities handbook,
cals now resides at the Bn level with the Surgeon and evacuation capability, reports (special operations
PA and all stamps have been distributed. Waivering debriefing and retrieval system [SODARS], AARs,
authority for any disqualifying condition remains Intellink), and special studies. If you have a military
with the SWCS Surgeon, COL Keenan. Profiling or government e-mail address, contact directly
for any heat or cold casualties now requires a http://mic.afmic.detrick.army.mil especially for
Medical Evaluation Board (MEB). Temporary pro- infectious diseases and environmental injuries.
files cannot exceed 90 days and no one should be on Suggested resources would be AFMIC, phone: 910-
profile in excess of one year. 432-9264. Other resources include TRAVAX.COM
Live Animals: Several approved exportable and PROMED, e-mail
animal use protocols exist. All physicians and vet- [email protected]. After logging on,
erinary surgeons require an 8-hour training block on type “SUBSCRIBE PROMED”. He stressed the
animal use. It is exportable, however, the Group importance of sending copies of OCONUS AARs
Surgeon and all veterinarians should attend the to him. You can contact him at 910-432-
course at Ft Bragg. A new protocol to recover ani- 9652/9264/2491 Fax 4292 DSN 239-xxxx STU III
mals from anesthesia is due in July 02 and will allow 9652.
for a UW/GW training focus for teaching other 18 Med Log: SFC Ramirez, 91S, reminded us
series and indigent soldiers. For all animal use out- that our med chem kits of the Mark I injector,
side of Ft Bragg, you must have an approved pro- CANA and PB tabs are centrally managed by the
tocol; inform the PI and the CG via USASOC MEDCOM and the request for release should go
Surgeon; use trained instructors; have students through USASOC Surgeon to the OTSG. There is
sign a letter of nondisclosure; and maintain records. a catalog of all available medical supplies at the special oper-
Reports: Both Command Health Report ations forces support activity (SOFSA).
(CHR) & 18D Quarterly Training Report (QTR) are Retention: AD 18Ds over 18 years will be
due by the 15th to MSG Capuzzo. Accuracy and given an opportunity to test for PA certification with
promptness are paramount. Deployment Health a four-year commitment if successful at the
Surveillance (DHS) is required for all OCONUS JSOMTC. Nothing will be funded centrally and no
missions regardless of length of stay. Complete additional time will be provided for preparation or testing.
DD2795 during the predeployment medical threat Opthalmic Surgery: MAJ Barnes, Deputy
brief with the original in the medical record and a Command Surgeon and Chief SOF Ophthalmologist,
copy to USSOCOM. TB skin testing should be with- reviewed keratorefractive surgery. Radial Kera-
6
Journal of Special Operations Medicine
otomy (RK) is never indicated and permanently dis- Blood Substitutes: MAJ John Mullen, 1st
qualifying and nonwaiverable, due to permanent SFG (A) Group Surgeon, presented a special talk on
residual weakness to the corneal structure because blood substitutes, Hemoglobin Based Oxygen
the incision depths are over 90% of the thickness of Carriers (HBOC), which should be considered a
the cornea. Photo Refractive Keratectomy (PRK) is drug that carries oxygen. Hemorrhage accounts for
approved after vision has stabilized as early as 3 the majority (60%) of preventable combat deaths
months post-surgery. Laser Assisted In-Situ and blood is difficult to transport and to store. Even
Keratomileusis (LASIK) is not approved for in major disasters, all blood supplies will be deplet-
SWCS schools but can be waived for SF duty ed within 10 days. Hemopure has the advantage
retention only after examined by a SOF ophthal- over Polyheme in that it does not require refrigera-
mologist. PRK and LASIK are similar in success tion. Hemopure has excellent oxygen exchange,
rates: 90-95% will see 20/40 or better but 1-2% will low viscosity and colloidal properties. Several
have permanent vision loss of 2 lines on the Snellen studies were reviewed. Clinical use is similar to
chart. LASIK is better in that the hazing and pain Hespan.
common to PRK is minimal to none. However, com- Live Tissue Protocols: MAJ Drew
plications associated with the corneal flap may Kosmowski, 7th SFG (A) Group Surgeon, present-
become extremely serious although rare. Most com- ed live tissue protocols on Combat Trauma
plications involve fungal infections and epithelial Management and Surgery. All participants sign
cell creep below the flap. Laser Assisted In-Situ non-disclosure statements and Battalion
Epithelial Keratomileusis(LASEK), a new modifica- Commanders cosign as adjunct principal investiga-
tion of the LASIK whereby a small epithelial corneal tors (PIs). There is an online training requirement
layer is rolled back, is promising and may greatly for all investigators including group and battalion
reduce some of these complications. COL surgeons and the commanders. They treated chest,
Enzenauer, 5/19th SFG (A) Bn Surgeon and paedi- abdominal and extremity wounds using a goat
atric ophthalmologist, recommends that PRK is best model and exported live tissue training OCONUS.
for nearsightedness or myopia less than 4 diopters. As a side note, Dr. Kosmowski delivered a baby
LASIK is better for myopes greater than 4 diopters. precipitously at a traffic checkpoint at Fort Bragg
Dr. Enzenauer also recommends that a corneal spe- recently.
cialist who does both procedures perform your sur- 10th SFG:MAJ Craig Durck, 10th SFG (A)
gery. My professional colleague and Army Reserve Group Surgeon, reviewed their activities and the
Oculoplastic Surgeon, Dr. Nevarez, concurs. importance of Medical Humanitarian Civic Actions
Chemical Bacteriological Radiological (Med HCAs) in making inroads with the Serbians,
(CBR): PT Sean Phelps, 1/1 SFG (A) Battalion especially the need for optometry and dentistry. In
Surgeon, discussed a training exercise involving the event of a life-ending injury to a military mem-
unknown CBR threats. He stressed the need to plan ber, a current leave earning statement (LES), com-
for a hasty recon before exfil and contamination con- manding officer’s (CO’s) letter stating no judicial
tainment plan. Two decon lanes are recommended actions pending, and MD’s letter of possible imm-i
whenever possible. Isolation for up to 17 days may nent death are all that is needed for medical retire-
be required for any potential biological agent expo- ment. These should be included in the servicemem-
sure. There is no substitute for field-testing all equip- bers retirement packet (SRP). This type of medical
ment and practice. Med Log, Med Opns and NBC retirement can be reversed. Live tissue training is
Officers have to coordinate both training and now incorporated in the Special Forces Advanced
response especially with medevac to higher echelons Urban Combat (SFAUC) course. He also went over
with the Air Force. NAVSPECWAR is the leading cold weather training opportunities and short dis-
authority in CBR for Special Operations and cussion on cold injury. He discussed a mine injury
SOCOM Manual 3-11 should be added to all SOF occurring on post. A team medic was new from
libraries. Biofoam by MODEC is the recommended school and spent considerable time discussing team
decon agent. A field expedient respirator can be made roles during a trauma incident which was very help-
with three folded layers of cotton over the nose and ful. It took approximately 45 minutes for the casu-
mouth, which will filter out 80% of all airborne par- alty to be picked up by helicopter. He was a multi-
ticles. ple trauma, including traumatic amputations and
Volume 2, Edition 1 / Winter 02 7